Pulmonary arterial hypertension is a rare, progressive disease with historically poor prognosis, though outcomes have improved with targeted pulmonary vasodilators. Findings presented at the European Society of Cardiology Congress 2025 evaluated the real-world effectiveness and safety of selexipag, an oral prostacyclin receptor agonist.

Ninety-seven patients treated between 2016 and 2022 were analyzed, including idiopathic/heritable pulmonary arterial hypertension (56%), connective tissue disease–associated pulmonary arterial hypertension (16%), and congenital heart disease–associated pulmonary arterial hypertension (20%). Mean age was 50 years, and 75 percent were female. Patients received a mean maintenance dose of 1.9 mg/day.

At 52 weeks, selexipag significantly reduced pulmonary vascular resistance and mean pulmonary artery pressure and improved six-minute walk distance. Most patients showed stable or improved COMPERA risk classification. Adverse events occurred in 62 percent, most commonly headache, diarrhea, nausea, and jaw pain, all requiring only symptomatic management.

These results support selexipag as an effective and well-tolerated oral therapy for improving hemodynamics, functional capacity, and risk profile in pulmonary arterial hypertension.